Immunization is a cost-effective public health intervention to decrease childhood morbidity and mortality. According to the 3rd National Family Health Survey (NFHS-3), 43.5% children aged 12 to 23 months were fully vaccinated. The 3rd District Level Household 8 Facility Survey (DLHS-3) showed 69% full-immunization coverage in Maharashtra with major regional variations. Rural Hospital, Panvel (Raigad), is in a peri-urban area providing health services to a mix of urban, rural, and migrant population. The study was conducted in this hospital with the aim to understand why people seeking health services for secondary prevention refrain from complying with routine immunization services.

To assess the reasons for partial and nonimmunization of the children and the knowledge regarding routine immunization.

All children who completed 1 year but below 5 years of age, attending the Rural Hospital, Panvel, during a period of 1 month from October 16 to November 15, 2014, were screened and those who were not fully immunized for the age were included in the study. Sociodemographic background, immunization status, reasons for partial and nonimmunization, and knowledge about routine immunization data were collected by personal interview using a prestructured, pretested questionnaire after obtaining informed consent.

Out of 303 children, 57 (18.8%) were found to be either partially immunized (47; 15.5%) or nonimmunized (10; 3.3%). The lack of knowledge (36%), lack of priority for immunization (33%), and poor communication by the health worker (21%) were the major reasons. 42% of the mothers were aware about the severity of the vaccine preventable diseases. However, 80% did not have the correct knowledge regarding the immunization schedule.

The opportunities to vaccinate are still being missed and consolidated efforts to improve the active involvement of mother in the immunization activity are required.

Sanjeev S, Waingankar P, Anjenaya S, Lohare BS. A Study of Reasons for Nonimmunization among Children attending the Services of a Rural Hospital in Raigad District, Maharashtra. MGM J Med Sci 2016;3(2):57-61.

The cemented total hip athroplasty (THA) has been in existence for about three decades; however, objective outcome analysis of patients subjected to this procedure in India is lacking. At Joint Replacement Centre, Military Hospital (MH), Kirkee, Pune, Maharashtra, India, a large database of total hip arthroplasties exists. The cemented hip arthroplasties are being done regularly at MGM Medical College 8 Hospital, Kamothe. However, the functional results of cemented hips operated from 2003 to 2015 have been analyzed to assess the objective outcome.

A prospective and retrospective study of 100 cemented hips in 92 patients between 26 and 78 years of age was carried out. Sixty-one (74%) patients were in the age group of 50 to 70 years. The diagnosis of these patients was avascular necrosis: 40; rheumatoid arthritis: 15; ankylosing spondylitis: 8; osteoarthritis: 12; fracture neck femur: 16; and fracture femoral head: 1. In all patients, cemented THA using Indian Orthopedics (INOR) indigenous and Zimmer implants were done. Three types of implants were used, Charnley 22 mm head, 26 mm head using INOR modular system and collarless polished tapered Zimmer system. Eight cases had bilateral involvement. The cases were followed up for varying periods from 1 to 10 years.

The results were assessed by utilizing Charnley activity and pain score. There were 83% excellent, 8% good, 5% fair, and 4% poor results. Three cases required revision, two because of frank loosening, and one due to acetabular malpositioning. Charnley pain score improved from 2.2 preoperatively to 5.2 postoperatively (+ 28.3% change).

The cemented THA is an excellent salvage procedure for advanced hip disorders resulting in pain and disability, especially in late age groups beyond 50 years.

Salgotra KR, Kohli S, Vishwakarma N, Chavan S. Cemented Total Hip Arthroplasty: A Study of 100 Cases. MGM J Med Sci 2016;3(2):62-65.

The maturation of respiratory system in children leads to changes in value of respiratory parameters like peak expiratory flow rate (PEFR), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and 6-minute walk distance (6MWD). Accurate analysis and clinical decisionmaking in disease state require reference values for different ages. The current study was undertaken to study pulmonary function and exercise capacity in children and adolescents.

After obtaining Institutional Ethical approval and parental informed consent, 262 subjects aged 9 to 15 years were recruited for the study. They were divided into two age groups, i.e., preadolescent (9–12 years) and early adolescent (13–15 years). Demographic details including age, sex, height, weight, and body mass index (BMI) were noted. Physical activity rating (PAR) scale was used to denote physical activity levels. Peak expiratory flow rate was measured using standard Mini-bell peak flow meter (PFM). The parameters MIP and MEP was measured using micro respiratory pressure meter, and 6-minute walk test (6MWT) was performed as per American Thoracic Society (ATS) guidelines.

A significant difference was noted between the two groups in PEFR, MIP, MEP, and 6MWD (p = 0.00). Age showed a strong positive correlation with PEFR (r = 0.613, p = 0.000), MIP (r = 0.676, p = 0.000), and MEP (r = 0.658, p = 0.00) whereas showed a strong negative correlation with 6MWD (r = –0.605, p = 0.00). Height showed a strong positive correlation with MEP (r = 0.720, p = 0.000) whereas a strong negative correlation with 6MWD (r = –0.42, p = 0.00). Weight showed a weak negative correlation with 6MWD (r = –0.328, p = 0.00). Gender difference was noticeable in 6MWD and PEFR (p = 0.00) but not in MIP (p = 0.45) and MEP (p = 0.44). Almost 22.10% of early adolescents were overweight compared to only 7.7% seen in preadolescent group.

PEFR and respiratory muscle strength was higher in early adolescents as compared to pre-adolescents. However, exercise capacity reflected by 6 MWD was found to be lower in early adolescents in comparison to pre-adolescents. These findings could be used while interpreting the outcome measures utilized while treating patients and for goal setting in cardiopulmonary rehabilitation in clinical practice.

Nair SP, Agarwal B, Shah M, Sawant S, Sinha N, Rajguru V, Mullerpatan R. Level of Physical Exercise Capacity, Respiratory Muscle Strength and Peak Expiratory Flow Rate in Healthy Adolescents. MGM J Med Sci 2016;3(2):66-71.

India was among the last few countries in the world to achieve leprosy elimination in 2005. However, wide variations in prevalence rates continue to exist across the states and regions in the country.

The purpose of the study is to determine the current clinical profile of leprosy from a tertiary-level hospital in Navi Mumbai.

A retrospective study was done to determine the epidemiological and clinical profile of leprosy patients in a tertiary care center, MGM Medical College 8 Hospital, Navi Mumbai (September 2011 to August 2015). Data regarding demographic details, clinical features, investigations, treatment, and complications were analyzed.

In total, 207 patients were registered over a 4-year period, with male:female ratio of 2.4:1 and children (. 14 years) constituting 7.2%. As per Ridley Jopling classification, borderline tuberculoid leprosy was the most frequent morphologic type, seen in 45.8%, followed by borderline lepromatous (28%), lepromatous leprosy (10.1%), and other forms in 11.5%. Multibacillary leprosy was the most common clinical type (81.1%). About 32.8% patients presented in reaction (type I in 22.7% and type II in 10.1%). World Health Organization (WHO) grade 2 deformities were diagnosed in 32.8%, with claw hand being the most common paralytic deformity (18.8%).

The study shows that despite statistical elimination, multibacillary disease, leprosy reactions, and deformities are commonly seen as presenting manifestations. Large population of migrant workers in Navi Mumbai could be a possible contributing factor towards these findings. It highlights the need to sustain and provide high-quality leprosy services to all patients through general health services, including good referral system. Investigations, such as slit skin smear and biopsy must be carried out for all newly diagnosed patients.

Ardeshna KP, Someshwar S, Rohatgi S, Dedhia AR, Jerajani HR. Leprosy Scenario at a Tertiary-level Hospital in Navi Mumbai: A Four-year Retrospective Study. MGM J Med Sci 2016;3(2):72-76.

To describe central venous catheter (CVC) colonizations and catheter-related bloodstream infections (C-RBSIs) among patients admitted in the Intensive Care Unit (ICU) of a tertiary care teaching hospital.

This was a cross-sectional study conducted among critically ill patients admitted in ICU. The semi-quantitative method was used for catheter tip culture. The definitions of catheter infection and colonization were based on the Centre for Disease Control Blood Stream Infection Guidelines.

The study population comprised 75 ICU patients whose CVCs had been placed. The incidence of CVC-related colonizations and bloodstream infections was observed to be 42.7% (32/75) and 17.3% (13/75) respectively. Coagulase-negative staph was the most common organism found causing CVC colonization (50%) and C-RBSI (61.5%).

Coagulase-negative staphylococci are the most frequent microorganisms which colonize the CVC. The findings of this study may help with implementation of educational and training programs on central line-associated bloodstream infections (CLABSIs) for health care personnel and enable better management of these devices with regard to the prevention, diagnosis, and treatment of CLABSIs.

Singh MK, Mallan D, Tripathi SS, Yadav RR, Avasthi S. A Study of Central Venous Catheter Colonizations and Catheter-related Bloodstream Infections among Patients admitted in the Intensive Care Unit of a Tertiary Care Teaching Hospital. MGM J Med Sci 2016;3(2):77-80.

Dent J. Essential Skills in Medical Education for Students: An Online Course in Medical Education for the Doctors of Tomorrow. MGM J Med Sci 2016;3(2):81-83.

Jindal GD, Sawant MS, Jain RK, Sinha V, Bhat SN, Deshpande AK. Seventy-five Years of Use of Impedance Plethysmography in Physiological Data Acquisition and Medical Diagnostics. MGM J Med Sci 2016;3(2):84-90.

Deshpande AK, Chauhan SG, Sood A. Takayasu's Arteritis. MGM J Med Sci 2016;3(2):91-95.

Deshpande S, Israni NA, Narayanam S, Dhiware N. Multiple Intraorbital Glass Foreign Bodies. MGM J Med Sci 2016;3(2):96-99.

Joseph S, Singhania P, Shringarpure S, Joshi N, Nathwani P, Lamba RS, Pujari N. A Rare Case of Urethral Duplication managed by Simple Meatal Correction. MGM J Med Sci 2016;3(2):100-102.

Shewale H, Wadke S, D'souza O, Kaur SP. Anesthetic Management of Atonic Postpartum Hemorrhage with Hemorrhagic Shock and Impending Cardiac Arrest for Emergency Peripartum Hysterectomy. MGM J Med Sci 2016;3(2):103-104.

Chatterji T, Das A, Sen M, Mittal V, Singh DK, Agarwal GR, Srivastava JK, Vanvani G, Joshi S. Chryseobacterium Indoloegenes Meningitis in a Patient with Ventriculo-peritoneal Shunt. MGM J Med Sci 2016;3(2):105-109.